囤积行为及共病神经精神症状的分类
Classification of hoarding and comorbid neuropsychiatric symptoms.
作者信息
Nutley Sara K, Striley Catherine W, Cottler Linda B, Eichenbaum Joseph, Nosheny Rachel L, Mackin R Scott, Mathews Carol A
机构信息
University of Florida, Department of Psychiatry, PO Box 100256, 1149 Newell Dr., L4-100, Gainesville, FL, 32611, USA.
University of Florida, Department of Epidemiology, PO Box 100231, Gainesville, FL, 32610, USA.
出版信息
Psychiatry Res Commun. 2025 Jun;5(2). doi: 10.1016/j.psycom.2025.100215. Epub 2025 May 21.
BACKGROUND
Psychiatric comorbidity and self-reported cognitive dysfunction are common among individuals with hoarding disorder (HD). However, common patterns of co-occurring neuropsychiatric symptoms, and their potential impact on the clinical manifestation of hoarding, including functional impairment, are not well-established.
METHODS
Latent class analysis (LCA) was used to identify and characterize distinct neuropsychiatric symptom subgroups among 7606 adult internet-based research participants who reported experiencing social impairment due to household clutter. An additional 1129 participants who screened negative but had evidence of hoarding on additional assessment ("false negative") were identified and compared to the LCA-identified classes. Demographic and clinical characteristics associated with class membership were assessed.
RESULTS
The best fitting model yielded five subgroups, including three subgroups characterizing individuals with hoarding symptoms: "hoarding only" (12.1 %), hoarding with depressive symptoms ("depressed + hoarding"; 11.8 %), and hoarding with depressive symptoms, inattention, and subjective memory decline ("multisymptomatic"; 14.6 %). These subgroups fell along a continuum of increasing neuropsychiatric burden, with individuals in the "multisymptomatic" class experiencing the greatest deficits to general functional ability and cognitive functioning, as well as elevated rates of comorbid neuropsychiatric diagnoses. The "false negative" group was similar to the "hoarding only" class, although comprised of a significantly higher proportion of male participants and married individuals.
CONCLUSIONS
Neuropsychiatric symptom patterns among individuals with hoarding are heterogenous in nature and uniquely associated with clinical features and functional outcomes. These findings may inform the development of targeted interventions for HD that include assessment and management of depressive symptoms, inattention, and memory.
背景
囤积障碍（HD）患者中精神疾病共病和自我报告的认知功能障碍很常见。然而，同时出现的神经精神症状的常见模式及其对囤积临床表现（包括功能损害）的潜在影响尚未明确。
方法
潜在类别分析（LCA）用于识别和描述7606名因家庭杂乱而报告有社交障碍的成年网络研究参与者中不同的神经精神症状亚组。另外识别出1129名筛查为阴性但在额外评估中有囤积证据的参与者（“假阴性”），并与LCA识别出的类别进行比较。评估与类别归属相关的人口统计学和临床特征。
结果
最佳拟合模型产生了五个亚组，包括三个表征有囤积症状个体的亚组：“仅囤积”（12.1%）、伴有抑郁症状的囤积（“抑郁 + 囤积”；11.8%）以及伴有抑郁症状、注意力不集中和主观记忆减退的囤积（“多症状”；14.6%）。这些亚组沿着神经精神负担增加的连续体分布，“多症状”类别的个体在一般功能能力和认知功能方面存在最大缺陷，同时共病神经精神诊断的发生率也更高。“假阴性”组与“仅囤积”类别相似，尽管男性参与者和已婚个体的比例明显更高。
结论
囤积患者的神经精神症状模式本质上是异质性的，且与临床特征和功能结果独特相关。这些发现可能为HD的针对性干预措施的制定提供信息，这些措施包括对抑郁症状、注意力不集中和记忆的评估与管理。
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